Case report describes low-impedance coronary-wire pacing during TAVR

A case-based report from Hainan General Hospital in Haikou, China, describes a temporary pacing configuration for transcatheter aortic valve replacement that uses two wires in separate anatomical locations. A coronary wire placed in the left coronary artery served as the anode, while a left ventricular wire served as the cathode. The authors report extremely low pacing impedance and voltage thresholds in patients at high risk of coronary obstruction, alongside their description of the technique as simple and reliable.

The report focuses on the electrical characteristics of this arrangement rather than comparative clinical outcomes. Conventional pacing over a wire during TAVR can result in high impedance and elevated voltage thresholds, which the authors say might lead to loss of capture and, potentially, valve embolization. In the illustrated configuration, the coronary wire and left ventricular wire form the pacing circuit, allowing the authors to report the unusually low impedance and voltage thresholds associated with their approach.

The supplied report does not provide comparative data showing that coronary-wire pacing reduces loss of capture, prevents valve embolization, improves procedural outcomes or outperforms conventional pacing over a wire. It also does not establish how often the reported electrical performance occurred across a larger patient population. The findings are therefore limited to the cases described and to the authors’ technical assessment of the configuration.

Coronary obstruction risk is part of the reported clinical context for the patients discussed, but the supplied evidence does not provide enough procedural detail to determine how the wires were positioned beyond their roles as anode and cathode, how the configuration interacted with other steps in TAVR, or which patients beyond the reported setting might be suitable candidates. The article presents coronary-wire pacing as a possible approach to wire pacing in TAVR and reports its observed electrical performance, but it does not support clinical recommendations or a conclusion that the technique improves patient outcomes.

Subject of Research: Case-based coronary-wire temporary pacing during transcatheter aortic valve replacement

Article Title: Pacing during TAVR through a coronary wire in the coronary artery and left ventricular wire

Article References: Ma, R., Zhang, L., Liao, W., & Wang, S. (2026). Pacing during TAVR through a coronary wire in the coronary artery and left ventricular wire. Frontiers in Cardiovascular Medicine, 13, Article 1955852. https://doi.org/10.3389/fcvm.2026.1955852

Image Credits: AI Generated

DOI: 10.3389/fcvm.2026.1955852

Keywords: TAVR, coronary-wire pacing, temporary pacing, pacing impedance, voltage threshold, left coronary artery, left ventricular wire, coronary obstruction, aortic valve replacement, case report, Pacing, during